Football Injuries: Measuring the Blows

A high-tech mouth guard sounds an alarm when there’s head trauma

Inside the offices of X2Impact, a two-year-old Seattle startup, sits a contraption that harks back to medieval times. The rig, fashioned out of metal scaffolding, yanks a football helmet high into the air and then hurls it into a stationary mount. WHACK! The sight alone is enough to induce a migraine.

That’s as it should be, considering X2Impact is trying to build a business around head trauma. Founders Christoph Mack, an inventor-for-hire who has worked with companies such as Nike, Apple, and Whirlpool, and Rich Able, a technology consultant whose son was knocked out cold during a football game, are seeking a better understanding of the cumulative toll that hits to the head take on athletes. When a player goes down, “everyone pores over the game video to find that one hit,” says Mack. “Well, the hit that led to the injury actually happened two weeks prior when the athlete tried to do a host of extraordinary things to get the coaches’ attention.”

To help construct a data trail, X2 created a smart mouth guard. When a collision occurs, the tiny accelerometers and gyroscopes embedded into the plastic record the data, and then algorithms set to work marrying the linear and rotational signals to provide a picture of what’s happening inside the skull. “We need to begin to understand the numbers behind the hits,” says Dr. Daniel Garza, medical director for the San Francisco 49ers and an assistant professor of orthopaedic surgery at Stanford. Garza road-tested the mouth guards on about three dozen Stanford football players last season.

X2’s technology arrives at a time when head trauma in sports has turned into a national concern. After years of ignoring scientific data that linked long-term health issues to brain trauma, the National Football League has begun using standardized tests to decide if a player should be pulled out of a game after taking a blow to the head. About 30 states now have laws that call for student athletes to be removed from play if they show symptoms of a concussion.

Yet as Garza points out, there’s no definitive way to make an assessment. “Whether you look for symptoms or results from clinical tests, there’s no gold standard,” he says. The mouth guards transmit data to a base station, which feeds it to Microsoft’s Azure data crunching service. A player’s activity is compared to a baseline diagnostic test and against data gathered from similar athletes. “If there is a monster hit or hits building up, then an alert is issued to the coaching staff,” says Mack.

X2’s invention got primetime attention in November when Stanford wide receiver Chris Owusu suffered a concussion while wearing the device. “We learned that there is the initial blow and then an immediate second acceleration when his body hit the ground,” says Garza. “It opens up a whole new window to studying whether the brain was made more susceptible to injury in just the millisecond after the collision.”

X2 and its manufacturing partner, Bite Tech, are now gearing up to introduce a commercial kit that includes dozens of mouth guards, charging systems, software, and the wireless devices for data transmission. Pricing will work out to about $150 per player. The startup’s backers include Jim L. Mora, the former head coach of the Seattle Seahawks and current head coach at UCLA. “For the first time, we are in a position to aggregate billions of data points and correlate it to individuals and their clinical outcomes later in life, which is the true promise of this technology,” says Mack.


    The bottom line: Kits containing dozens of sensor-packed mouth guards created by a two-year-old Seattle startup may soon go on sale.

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